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NPI Code Detail

MEDICARE: HEALTH SPECIALISTS OF DAYTON INC

MEDICARE: HEALTH SPECIALISTS OF DAYTON INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225082134
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH SPECIALISTS OF DAYTON INC
Provider Business Mailing Address
First Line : 1126 S MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45409-2687
Country : US
Telephone Number : 937-223-3053
Fax Number : 937-853-0166
Provider Business Practice Location Address
First Line : 1126 S MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45409-2687
Country : US
Telephone Number : 937-223-3053
Fax Number : 937-853-0166
Authorized Official
Title or Position : CEO/PRESIDENT
Name : KENNETH PRUNIER
Credential :
Telephone Number : 937-208-8213
Provider Enumeration Date : 05/22/2006
Last Update Date : 05/05/2010

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Directions to “HEALTH SPECIALISTS OF DAYTON INC ” Practice Location

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